Acta Medica Lituanica最新文献

{"title":"Determinants of Parental Attitudes towards Children’s Vaccination in Lithuania: An Online Survey","authors":"Kamilė Čeponytė, Eglė Narkevičiūtė, Aušra Beržanskytė, Sigita Burokiene","doi":"10.15388/amed.2024.31.1.7","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.7","url":null,"abstract":"Background: Data from recent years show that the COVID-19 pandemic has significantly reduced the scope of child immunisation worldwide. If the numbers continue to fall, we may have a vaccination crisis. In order to understand the local factors of this phenomenon, we studied parents‘ viewpoint towards childhood vaccination in Lithuania. Therefore, the aim of our study was to determine the impact of parental attitudes on children’s vaccination.Materials and Methods: A web-based cross-sectional study was made in Lithuania from October 20th to November 3rd, 2020, using Google Forms. An anonymous questionnaire included both quantitative and qualitative questions. The questionnaire was distributed to the general population in Lithuania via social media and a snowball sampling. Only parents who have at least one child under 18 years old were involved in the study. We analysed the parents’ attitudes towards vaccination by their socioeconomic and demographic determinants using MS Excel and OpenEpi tools. The respondents were considered vaccine supporters if they vaccinated all their children with state-reimbursed vaccines or only vaccinated some of their children, and vaccine sceptics if they did not vaccinate their children with state-reimbursed vaccines.Results: The population of our research consisted of 775 parents. There were more males against vaccination than females, respectively, 59.6% and 33.2%. 65.0% of all respondents stated that they vaccinated their children with the full course of vaccines, while the remaining 35.0% did not vaccinate. University-level education dominated in both pro-vaccine and anti-vaccine groups. We found that 16.9% of parents who were unvaccinated as children themselves tend not to vaccinate their children. However, in the pro-vaxx group, only 0.7% of parents were unvaccinated during childhood. 50.8% of vaccine sceptics were not fully informed by healthcare professionals about the benefits and risks of vaccination, while only 31.6% of vaccine supporters were not informed. Social environment did not have an impact on the decision whether to vaccinate or not to vaccinate a child among both vaccine advocates and vaccine deniers (accordingly, 51.2% and 42.9%). 29.3% of respondents stated that the cost of paid vaccinations was too high. Open-text survey responses gave us more in-depth insight about the parental decision-making process. Protection of children and society from infectious diseases (31.7%) was mentioned as the main reason for vaccination. Whereas vaccine-hesitant parents were mostly concerned about already-occurring side effects or their risk (43.4%).Conclusions: Our findings confirmed that vaccine hesitancy was associated with not being vaccinated in childhood themselves, lack of information from medical practitioners and male gender. The price of vaccines also had an impact on immunisation rates – more than one-third of the vaccine supporting parents indicated that the cost of paid vaccinations was too high. Th","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"88 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141004229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deaths during Sexual Activity","authors":"Agnė Okulevičiūtė, Sigitas Chmieliauskas, Sigitas Laima, Diana Vasiljevaitė, Jurgita Stasiūnienė","doi":"10.15388/amed.2024.31.1.8","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.8","url":null,"abstract":"Background: Deaths during sexual activities are a rarely identified phenomenon in forensic medicine practice. Most often, such deaths are classified as accidents or deaths due to the manifestation of certain diseases during sexual activity. It is important to rule out homicide or suicide as the cause of death when investigating sexual deaths. Determining the cause of death requires a comprehensive assessment of the evidence and circumstances and should not be based solely on autopsy findings. When determining the cause of death, it is necessary to evaluate the circumstances of the discovery, important evidence found near the body, the position of the deceased, the place where the deceased was found, and the characteristics of the environment.\u0000Cases: Case 1: A 65-year-old male was clothed in women’s underwear and was found hanging in a noose in a bedroom after a house fire. The autopsy revealed a ligature mark on the neck, bruises in neck muscles, tears in carotid arteries, and signs of acute pulmonary distension. The cause of death was determined to be suffocation due to neck compression by a ligature, compounded by significant alcohol intoxication, with additional postmortem burns covering 30% of the body surface area likely occurring after death.\u0000Case 2: A 55-year-old naked male was found without external injuries but with a plastic tube inserted into the rectum, causing a 2.5 cm rupture in the ileum. The perforation led to complications, including purulent diffuse peritonitis, intoxication, and acute cardiac and respiratory failure, resulting in death within 3-6 hours after insertion. Concurrent findings included atherosclerotic changes in the heart, internal organ hyperemia and edema, hepatic steatosis, renal cyst, and a lack of ethyl alcohol in blood but 0.17 ‰ presence in urine according to toxicology analysis.\u0000Conclusions: A detailed evaluation of all the evidence is very important in the forensic examination of the deceased during sexual activity. Therefore, to determine the cause of death, not only the autopsy data, toxicological and microscopic examinations of the deceased are important, but also the evaluation of all findings at the scene. The most common cause of death of an autoerotic nature is asphyxia, and the most commonly identified group of the dead are men aged around 40 years.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"66 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141003132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wunderlich Syndrome Managed with Angiomyolipoma Embolization – Renal Artery Anatomic Variant Augmenting Safe and Nephron-Sparing Intervention","authors":"Tara Prasad Tripathy, Alamelu Alagappan, R. Patel, Srikant Kumar Behera, Sandip Kumar Panda, Suprava Naik","doi":"10.15388/amed.2024.31.1.3","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.3","url":null,"abstract":"Background: Wunderlich syndrome is an uncommon entity characterized by spontaneous, nontraumatic renal bleeding into the subcapsular and perirenal regions. The most frequent benign tumor, angiomyolipoma, is the most common cause of Wunderlich syndrome.Case presentation: We report a case of Wunderlich syndrome in angiomyolipoma. Intratumoral pseudoaneurysm arising from feeders of an accessory renal artery supplying the lower pole of the kidney was selectively embolized. Rarely does a sporadic renal angiomyolipoma develop a giant pseudoaneurysm.Conclusion: Transarterial embolization is imperative to control the bleeding or as a preventative measure to reduce the risk of intralesional pseudoaneurysm rupture. When vascular interventional facilities are unavailable, surgery may be necessary.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"21 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140265097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hematohidrosis in Pediatric Practice  – a Case Report and Review of the Literature","authors":"Oksana Matsyura, Lesya Besh, Svitlana Jefimova, Kh.B. Slivinska-Kurchak, Sergiy Gerasymov","doi":"10.15388/amed.2024.31.1.2","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.2","url":null,"abstract":"Hematohidrosis (bloody sweat) is a symptom of trophic damage to the vascular wall, in which sweat mixes with blood and seeps onto undamaged areas of the skin in the form of red or pink liquid (depending on the ratio of sweat to blood).  In our study we have analyzed 25 case reports of hematohidrosis in children, reported throughout the world using PubMed, ResearchGate with detailed description and opened access. We took into consideration: age of the patient, sex, location of bloody excretion, cause or trigger, treatment and its effectiveness.Our clinical case present a 9-year-old girl complained of a periodic bleeding from the intact skin of the face, neck, thighs (without visible damage to the skin) manifested by red or pink liquid, nosebleeds, and bloody discharge from the mucous membrane of the eyes. The secretions were of varying intensity and lasted up to several hours. Most of all episodes are associated with a strong emotional exertion. One of the theories of hematohidrosis pathogenesis is evident vasoconstriction of the blood vessels surrounding the sweat glands, provoked by hyperactivation of the sympathetic nervous system, which is followed by their excessive vasodilation up to rupture and blood entering the sweat gland ducts. Capillary endothelial cells are known to contain β2-adrenoceptors, which, through the modulation of nitric oxide release, cause endothelium-dependent vasodilation. Blocking β-adrenoceptors (for example, propranolol) prevents excessive vasodilation of blood vessels and, accordingly, their rupture and blood flow to the sweat gland.We managed to find out that the patient’s bloody sweat was a manifestation of a separate pathological phenomenon, and not one of the symptoms of another disease. A properly formed treatment complex and the great trust of the parents enabled to stabilize the child’s condition, and later to cure her. Currently, hematohidrosis is recognized as an independent disease that requires in-depth study of the triggering mechanisms of development, pathogenetic and clinical features.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140413306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Renal Hilar Nutcracker Phenomenon in a Male Cadaver","authors":"D. Borthakur, Rajesh Kumar, V. Dhawan, Rima Dada","doi":"10.15388/amed.2024.31.1.6","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.6","url":null,"abstract":"Nutcracker phenomenon (NCP) typically refers to the entrapment of the left renal vein (LRV) between the aorta and the superior mesenteric artery. Similar to the classic NCP, the renal vein can also get entrapped between the segmental branches of the renal artery at the renal hilum, which has been referred to as ‘renal hilar nutcracker phenomenon (RHNP).’ During routine dissection of a male cadaver of 67 years, the renal veins of both sides at the renal hilum were seen between the segmental branches of renal arteries, which we identified as the ‘renal hilar nutcracker phenomenon.’ The disposition of the rest of the perihilar structures was normal. ‘Renal hilar nutcracker phenomenon’ can have similar clinical presentation like that of the nutcracker phenomenon. Hence, knowledge of such anatomical variation at the renal hilum is desirable.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"36 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140421810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lithium Induced Amenorrhea: A First Case Report","authors":"Balakumar Ke, Vidhya Egambarame, Vandana Tayal","doi":"10.15388/amed.2024.31.1.5","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.5","url":null,"abstract":"A 19-year-old female, known case of bipolar disorder had history of amenorrhea (absence of menstruation) for three years. While other causes of amenorrhea such as CNS, pregnancy, other medications, and thyroid issues were ruled out, she was found to have hyper-prolactinemia. Although antipsychotic medications are known to cause amenorrhea due to dopamine receptor blockade, which may result in hyperprolactinemia, the patient’s symptoms began before she started these medications. Only drug that she was on for long period is lithium. Current literature shows mixed evidence about lithium’s impact on prolactin levels, which can affect menstruation. This case may represent the first report of lithium causing amenorrhea through elevated prolactin levels. Clinicians should be aware of this potential side effect and monitor patients accordingly. Further studies are needed to confirm and understand this potential link.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"28 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140427313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Unusual Case of Denervation Changes of the Intercostal Muscles Associated with Intercostal Neuralgia in a Patient with Chest Pain","authors":"R. Botchu, Lorraine Aspland, Sisisth Ariyaratne, James Burgess, Gurjit Bhogal, David Beale","doi":"10.15388/amed.2024.31.1.4","DOIUrl":"https://doi.org/10.15388/amed.2024.31.1.4","url":null,"abstract":"Musculoskeletal aetiologies account for most patients presenting with chest pain. Intercostal neuralgia is a lesser-known cause of musculoskeletal chest pain, which can present a diagnostic challenge with nonspecific imaging findings. We report a case of a 31-year-old male who presented with severe lower thoracic and chest wall pain following a suspected viral infection, where Magnetic Resonance Imaging (MRI) revealed characteristic features of denervation oedema within the affected intercostal muscles. This pattern of imaging findings in intercostal neuralgia is sparely described in the current literature. MRI along with history and examination was crucial in diagnosing the condition and excluding other potential causes of musculoskeletal chest wall pain on this occasion. The patient’s symptoms were subsequently managed conservatively. The case highlights the importance of considering intercostal neuralgia as a potential cause of chest wall pain, particularly in the setting of post viral infection and absence of preceding mechanical musculoskeletal injury and explores an uncommon yet characteristic imaging finding which may be important in diagnosing the condition.","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"99 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140426489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Resolution of Congenital Intrahepatic Portosystemic Shunt.","authors":"Taraprasad Tripathy, Sandeep Behera, Ranjan Patel, Tanmay Dutta, Aditi Kumar, Amit Kumar Satpathy","doi":"10.15388/Amed.2024.31.2.14","DOIUrl":"10.15388/Amed.2024.31.2.14","url":null,"abstract":"<p><p>Congenital portosystemic shunts (CPSS) are a rare type of congenital abnormality. It results from abnormal embryonic development by the fourth week of fetal life. Congenital portosystemic shunts are believed to signify persistent communication between the portal and vitelline venous systems. Both extrahepatic and intrahepatic shunts are possible. They may develop on their own or in association with other congenital abnormalities. With regard to shunt type and size, symptoms vary widely. The anatomy of the shunt and associated abnormalities can be assessed by computed tomography and magnetic resonance angiography. The treatment plan is based on the type of shunt, its location and level of function, the patient's age, and the severity of their symptoms.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"382-387"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review of Open Access, No-Fee Journals Indexed in PubMed and Scopus for Publishing Image Reports in Medical Research.","authors":"Gabriele Gaggero","doi":"10.15388/Amed.2024.31.2.21","DOIUrl":"10.15388/Amed.2024.31.2.21","url":null,"abstract":"<p><strong>Background: </strong>Aspects of medicine can be conveyed through paradigmatic images (anatomical-surgical, radiological, microscopic) in image reports, a type of article more immediate than case reports. The aim of this review is to find journals allowing the publication of image reports and that are free of charge, open access and indexed in the best databases.</p><p><strong>Methods: </strong>The search started with a Boolean string and followed the PRISMA 2020 guidelines. Eligibility criteria were: English language, human medicine field, international DOI and ISSN codes applied, free of charge, open access, PubMed/Scopus indexed.</p><p><strong>Results: </strong>15,504,000 items were retrieved; 102 met all criteria. Instructions to authors were screened to extract journals that allowed image reports: 39 (39/39 Scopus-indexed; 29/39 PubMed-indexed). Most were in oncology (6/39) and general medicine (5/39), followed by neuroscience, fetal/pediatric and nephrology (4/39 each), urology, dermatology, hematology (3/39 each), thoracic/pleural/peritoneal diseases (2/39), and finally endocrinology, cytology, rheumatology, ophthalmology, gastroenterology (1/39 each). 21/39 allowed a single image; word count ranged from 100 to 1500. 32/39 reported a maximum number of references (range: 0-20), while 15/39 reported a maximum number of authors (range: 2-6).</p><p><strong>Conclusions: </strong>Compared to the vast publishing landscape, there are very few English-language, open access, PubMed/Scopus-indexed medical journals that allow free of charge publication of image reports. The majority are in the fields of oncology and general medicine, but other specialties are also represented. Image reports are usually articles with a limited number of words, references and authors allowed, as their purpose is much more a practical/didactic take-home message rather than a broad research with many authors. The review shows that image reports, still important for their educational value in medical knowledge transfer, are freely publishable and consultable in journals with international visibility.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"245-253"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conservative Management of Delayed Submucosal Bleeding after Per-Oral Endoscopic Myotomy: A Case Report.","authors":"Martina Marrelli, Dario Biasutto, Benedetto Neri, Serena Stigliano, Citterio Nicolò, Monica Pandolfi, Gianluca Andrisani, Francesco M Di Matteo","doi":"10.15388/Amed.2024.31.2.15","DOIUrl":"10.15388/Amed.2024.31.2.15","url":null,"abstract":"<p><p>Per-Oral Endoscopic Myotomy (POEM) is recognized as the first-line therapy for achalasia, considering its high clinical efficacy and safety. Among the most important adverse events, bleeding or hematoma in the submucosal tunnel has incidence of approximately 1%. We describe the case of woman affected by type II achalasia, treated with POEM, who presented delayed bleeding with submucosal hematoma after starting anticoagulant therapy with subcutaneous low molecular weight heparin (LMWH). She presented with moderate-to-severe chest pain, stable vital signs and no evidence of arterial active bleeding. Therefore, urgent esophagogastroduodenoscopy was not performed, and the patient was treated conservatively with fasting, antibiotics, LMWH discontinuation and close medical supervision. After 10 days the condition was resolved, and the patients safely discharged. The present case report adds support to the safety and efficacy of conservative management of submucosal hematomas occurring after POEM.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"31 2","pages":"388-393"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}